Changes

Also known as: '''''Tooth Extraction'''''

Also known as: '''''Tooth Extraction'''''

*Worn tooth with pulp exposure

*Worn tooth with pulp exposure

*Crown root fracture

*Crown root fracture

*Odontoclastic resorptive lesion

*[[FORL|Odontoclastic resorptive lesion]]

*Caries lesion

*[[Dental Caries|Caries lesion]]

*Non-vital tooth

*Non-vital tooth

*Persistent deciduous teeth

*[[Persistent Deciduous Teeth|Persistent deciduous teeth]]

*Teeth involved in a jaw fracture

*Teeth involved in a jaw fracture

*Unerupted teeth causing pathology

*Unerupted teeth causing pathology

*Teeth causing malocclusions

*[[Dental Malocclusion|Teeth causing malocclusions]]

*Supernumerary teeth

*[[Tooth Eruption Disorders#Supernumerary Teeth|Supernumerary teeth]]

*Chronic gingivostomatitis

*Chronic gingivostomatitis

==Patient Preparation==

==Patient Preparation==

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====Applying the Principles to the Lower Canine Tooth====

====Applying the Principles to the Lower Canine Tooth====

The basic principles described above are used for the mandibular canine with the following exceptions<span style="color:#ff0000">Is this perhaps a bit confusing, since the exceptions are not canines?</<span>.

The basic principles described above are used for the mandibular canine with the following exceptions:

 

:Care should be taken when placing the vertical releasing incisions and raising the flap to avoid damaging the inferior alveolar blood vessels and nerve exiting the middle mental foramen. A longer releasing incision can be made rostrally creating more of a triangular flap.  

Care should be taken when placing the vertical releasing incisions and raising the flap to avoid damaging the inferior alveolar blood vessels and nerve exiting the middle mental foramen. A longer releasing incision can be made rostrally creating more of a triangular flap.  

:Dental elevators should not be placed directly mesially and distally but rather on the mesiolingual and distolingual aspects of the tooth. This is to avoid fracture of the rostral mandible.

 

Dental elevators should not be placed directly mesially and distally but rather on the mesiolingual and distolingual aspects of the tooth. This is to avoid fracture of the rostral mandible.

==Maxillary Fourth Premolar Tooth Extraction==

==Maxillary Fourth Premolar Tooth Extraction==

#In young puppies or persistent deciduous teeth where the root is not being resorbed, raise a small mucoperiosteal flap – a no.11 scalpel blade can be used to make the releasing incisions then a periosteal elevator to raise the flap.  

#In young puppies or persistent deciduous teeth where the root is not being resorbed, raise a small mucoperiosteal flap – a no.11 scalpel blade can be used to make the releasing incisions then a periosteal elevator to raise the flap.  

#Use a small round bur to remove buccal bone. Care must be taken not to damage the root of the permanent or adjacent teeth  

#Use a small round bur to remove buccal bone. Care must be taken not to damage the root of the permanent or adjacent teeth  

#Use a small elevator (eg.superslim which is 1.3mm width) to gently luxate the tooth taking care not to position the elevator in a position where the permanent tooth could be damaged. If extracting the mandibular deciduous canines, no instrument should be placed on the lingual (inner) aspect of the tooth as this will damage the permanent developing mandibular canine <span style="color:#ff0000">(lower arrow)</span> and probably also the 3rd incisor <span style="color:#ff0000">(top arrow)</span>. If extracting maxillary deciduous canines take care placing any instrument on the mesial (front edge) aspect as the permanent tooth bud develops in front of the deciduous tooth.  

#Use a small elevator (eg.superslim which is 1.3mm width) to gently luxate the tooth taking care not to position the elevator in a position where the permanent tooth could be damaged. If extracting the mandibular deciduous canines, no instrument should be placed on the lingual (inner) aspect of the tooth as this will damage the permanent developing mandibular canine and probably also the 3rd incisor. If extracting maxillary deciduous canines take care placing any instrument on the mesial (front edge) aspect as the permanent tooth bud develops in front of the deciduous tooth.  

#Gently rotate and luxate the deciduous tooth. Once there is some mobility, use extraction forceps with a small beak (pattern 76N) in a rotational manner to break down any remaining fibres prior to the tooth being lifted out of the socket.  

#Gently rotate and luxate the deciduous tooth. Once there is some mobility, use extraction forceps with a small beak (pattern 76N) in a rotational manner to break down any remaining fibres prior to the tooth being lifted out of the socket.  

#Suture the flap closed using a Fine (1 metric) monofilament absorbable suture material with simple interrupted sutures ensuring that there is no tension on the sutures.

#Suture the flap closed using a Fine (1 metric) monofilament absorbable suture material with simple interrupted sutures ensuring that there is no tension on the sutures.

==Special Considerations for Feline Dentistry==  

==Special Considerations for Feline Dentistry==  

===Crown Amputation for Type 2 Resorptive Lesions <span style="color:#ff0000">(pic21-27)</span>===

===Crown Amputation for Type 2 Resorptive Lesions===

This technique is used when a tooth is undergoing resorption and there is no normal root structure remaining. This technique can only be used after a diagnosis of type 2 resorptive lesions has been made radiographically.  

This technique is used when a tooth is undergoing resorption and there is no normal root structure remaining. This technique can only be used after a diagnosis of type 2 resorptive lesions has been made radiographically.  

A chlorhexidine mouthwash can be dispensed for the owner to use at home to help reduce plaque buildup whilst the mouth is healing. If none or few extractions were performed then tooth brushing can be instigated immediately.   

A chlorhexidine mouthwash can be dispensed for the owner to use at home to help reduce plaque buildup whilst the mouth is healing. If none or few extractions were performed then tooth brushing can be instigated immediately.   

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[[Category:Dental Surgical Procedures]]

[[Category:Dental Surgical Procedures]]

[[Category:To Do - Dentistry preMars]]

[[Category:Waltham reviewed]]